MEDICARE: DARRON SCOTT BAILEY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251G0304X	Geriatric Physical Therapist

General Provider Information

NPI Number	:	1659836112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRON SCOTT BAILEY PT

Provider Business Mailing Address
First Line	:	2903 S WALLS DR
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47403-4369
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 S HASTINGS DR
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401-8205
Country	:	US
Telephone Number	:	844-325-8230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	02/08/2019

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